Health Care Reform in China: An Analysis of Development Trends and Lack of Implementation

ABSTRACT

China's health care system, under the direction of the central government, has undergone continuous reform in recent decades. Many problems have been encountered, with successive measures attempting to deal with shortcomings and failings of previous reforms. To what extent can implementation failures account for the recurring problems, and what explains these failures? The analysis adopts the theoretical lens of structural-instrumental and cultural-institutional perspectives, respectively, and draws also on recent developments in implementation theory. The historical trajectory of health reform is described, with particular reference to why health policies formulated by the central government during different periods repeatedly failed to achieve their objectives. The empirical analysis finds that structural factors, such as departmentalism and regional separation resulting in complex, overlapping horizontal and vertical actor patterns, have been a primary reason for implementation failures and suggests that they will continue to dog future reform efforts.     

The theory of the state and politics: a central paradox of Marxism

It is commonplace to observe that while Marx saw the withering away of the state as necessary for communism, the state in ‘Communist’ societies has done anything but wither away. This seems to indicate a paradox in the Marxian theory, whose resolution would probably tend to undermine the theory itself. It is, however, argued that the expansion of the state in ‘Communist’ societies is only apparently contradictory to the Marxian theory, and that the theory in fact provides the basis for a most adequate account of this phenomenon. But the theory does have a genuinely paradoxical quality which lies in the tension between the political and its social basis, in the socialist movement. The fundamental component of the Marxian theory is its demonstration of the dependence of the state and politics on society; the problem then is the very status of ‘the political’ as a category, and especially the meaning of a ‘marxist politics’. Marxism itself demonstrates that the very existence of ‘politics in the direct and narrow sense of the word’ is the product of an alienated society, and yet it posits a politics which necessarily exists partly in this very sense. This paper considers the Marxian theory and the problems it tries to deal with, and attempts to show that the solution to its paradox lies in resolving the real tension between the social movement and its political expression. It will be argued that terms of the dilemma are being modified by changes in the relations between the state and society. These changes make a political solution of social contradictions more possible, precisely because they reduce the abstraction of politics from society.     

Globalization and the Korean electronics industry

Abstract

Northeast Asia is notable for the relative absence of regional institutions. The Six Party Talks could constitute an embryonic starting point for the development of such institutions. The path toward greater institutionalization is likely to begin in a modest fashion. Functional working groups on topics such as the environment, maritime transport, technical barriers to trade, road and rail links, and energy could provide the locus for integrating North Korea into the broader regional and global economies. Foreign ministries will inevitably take the lead in developing the Northeast Asia Peace and Security Mechanism (NEAPSM), but meaningful economic achievements will require the involvement of other ministries. North Korea has proved problematic in this regard thus far. Moreover, given the importance of private-sector involvement in achieving sustainable economic development in North Korea, modalities will have to be developed to integrate private-sector actors when possible. The governments of the region, and particularly China and South Korea, may continue support on a bilateral basis as a hedge against North Korea's collapse or as inducements in the context of the nuclear talks. But the development of more permanent multilateral structures is unlikely until the nuclear issue is resolved.     

Influence of Industry on Legislative Behavior toward NASA

This article explores economic factors that help to explain Congressional support for NASA Authorization Acts and issues of U.S. federal space funding. Three economic factors related to political opportunism are identified and discussed in detail. Across the board, NASA Centers are a significant factor in shaping voting preferences, suggesting that the NASA presence itself plays an important role in influencing legislators. Meanwhile, other forms of economic opportunism based on the relative importance of the space and aircraft manufacturing industries in a given state and the amounts of NASA procurements are factors, but only in a more limited sense. This supports the concept that economic opportunism does influence legislative voting behavior on NASA Authorization Acts, though the bulk of the impact appears to be indirectly via NASA centers.     

Satisfaction with democracy and collective action problems: the case of the environment

Whether a country is able effectively to address collective action problems is a critical test of its ability to fulfill the demands of its citizens to their satisfaction. We study one particularly important collective action problem: the environment. Using a large panel dataset covering 25 years for some countries, we find that, overall, citizens of European countries are more satisfied with the way democracy works in their country if (a) more environmental policies are in place and if (b) expenditures on the environment are higher, but environmental taxes are lower. The relation between environmental policy and life satisfaction is not as pronounced. The evidence for the effect of environmental quality on both satisfaction with democracy and life satisfaction is not very clear, although we find evidence that citizens value personal mobility (in terms of having a car) highly, but view the presence of trucks as unpleasant. We also document that parents, younger citizens, and those with high levels of educational attainment tend to care more about environmental issues than do non-parents, older citizens, and those with fewer years of schooling.     

A New Phase of European Integration: Organised Capitalisms in Post-Ricardian Europe

In the past, economic integration in Europe was largely compatible with the preservation of different national varieties of capitalism. While product market integration intensified competition, member states could build on and foster their respective comparative advantage. Today, this no longer unequivocally holds true. This article contends that a new, ‘post-Ricardian’ phase of European integration has emerged in which the Commission's and the European Court of Justice's (ECJ's) attempts to promote economic integration systematically challenge the institutions of organised capitalism. It demonstrates this by discussing recent disputes over the Services Directive, the Takeover Directive, and company law. In the current phase of European integration, the Commission's and the ECJ's liberalisation attempts either transform the institutional foundations on which some of the member states' economic systems rely or they create political resistance to an extent that challenges the viability of the European project.     

Book reviews

Patterns of Democracy. Government Forms and Performance in Thirty‐Six Countries. By Arend Lijphart. New Haven and London: Yale University Press, 1999. Pp.351, biblio., index. £26 (cloth); £10.95 (paper) ISBN 0–300–07893–5.

Critical Citizens. Global Support for Democratic Governance. Edited by P. Norris. Oxford : Oxford University Press, 1999. Pp.xv + 303, 37 figures, 59 tables, biblio, index. £45 (cloth) ISBN 0–19–829479–4.

Continuity and Change in Contemporary Capitalism. Edited by H. Kitschelt, P. Lange, G. Marks and J.D. Stephens. Cambridge: Cambridge University Press, 1999. Pp.xiii + 527, biblio, index. £45 (US$69.95) (cloth) ISBN 0–521–62446–2; £16.95 (US$27.95) (paper) ISBN 0–521–63496–0.

Comparative Public Policy ‐ Patterns of Post‐war Transformation. By Francis G. Castles. Cheltenham: Edward Elgar, 1998. Pp.368, £59.95 (cloth) ISBN 1–858989–816–0; £19.95 (paper) ISBN 1–858989–823–3.

The Political System of the European Union. By S. Hix. London: Macmillan, 1999. Pp.ix + 427, 52 tables and 28 figures, biblio, index. £16.99 (paper) ISBN 0–333–71654‐X; £49.50 (cloth) ISBN 0–333–71653–1.

The Long Presidency. France in the Mitterrand Years, 1981–1995. By Julius Friend. Boulder, CO and Oxford: Westview Press, 1998. Pp.xi + 308, biblio, index. £30.95 (cloth) ISBN 0–8133–2850–0.

Historical Dictionary of Modern Italy. Edited by Mark F. Gilbert and K. Robert Nilsson. The Scarecrow Press, Lanham, Maryland and London, 1999. Pp.xxxvi + 463. 18 tables. $65 (cloth) ISBN 0–8108–3584–3

Zukunft der Sozialpartnerschaft: Veränderungsdynamik und Reformbedarf. Edited by F. Karlhofer and E. Tálos. Vienna: Signum, 1999. Pp.301, 9 tables, 3 figures, ATS 350 ISBN 3–85436–297–8.

Geografia della cittadinanza sociale in Italia. By Valeria Fargion. Bologna: II Mulino, 1997. Pp.351, biblio, index. L.45,000 (paper) ISBN 88–15–06127–4.     

Thinking Critically About Rural Gender Relations: Toward a Rural Masculinity Crisis/Male Peer Support Model of Separation/Divorce Sexual Assault

After decades of neglect, a growing number of scholars have turned their attention to issues of crime and criminal justice in the rural context. Despite this improvement, rural crime research is underdeveloped theoretically, and is little informed by critical criminological perspectives. In this article, we introduce the broad tenets of a multi-level theory that links social and economic change to the reinforcement of rural patriarchy and male peer support, and in turn, how they are linked to separation/divorce sexual assault. We begin by addressing a series of misconceptions about what is rural, rural homogeneity and commonly held presumptions about the relationship of rurality, collective efficacy (and related concepts) and crime. We conclude by recommending more focused research, both qualitative and quantitative, to uncover specific link between the rural transformation and violence against women. This paper was presented at the 2006 annual meeting of the American Society of Criminology, Los Angeles, California. Some of the research reported here was supported by National Institute of Justice Grant 2002-WG-BX-0004 and financial assistance provided by the College of Arts and Sciences and the Office of the Vice President for Research at Ohio University. Arguments and findings included in this article are those of the authors and do not represent the official position of the US Department of Justice or Ohio University. Please send all correspondence to Walter S. DeKeseredy, e-mail: walter.dekeseredy@uoit.ca. All of the names of the women who participated in DeKeseredy and colleagues’ rural Ohio study and who are quoted have been changed to maintain confidentiality.

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